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Titolo:
High-volume haemofiltration in human septic shock
Autore:
Cole, L; Bellomo, R; Journois, D; Davenport, P; Baldwin, I; Tipping, P;
Indirizzi:
Austin & Repatriat Med Ctr, Dept Intens Care, Melbourne, Vic, Australia Austin & Repatriat Med Ctr Melbourne Vic Australia ourne, Vic, Australia Hop Laennec, Dept Anaesthesiol, F-75340 Paris, France Hop Laennec Paris France F-75340 ept Anaesthesiol, F-75340 Paris, France Monash Med Ctr, Dept Med, Melbourne, Vic, Australia Monash Med Ctr Melbourne Vic Australia pt Med, Melbourne, Vic, Australia
Titolo Testata:
INTENSIVE CARE MEDICINE
fascicolo: 6, volume: 27, anno: 2001,
pagine: 978 - 986
SICI:
0342-4642(200106)27:6<978:HHIHSS>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
INFLAMMATORY RESPONSE SYNDROME; CONTINUOUS ARTERIOVENOUS HEMOFILTRATION; CONTINUOUS VENOVENOUS HEMOFILTRATION; CYTOKINE REMOVAL; ENDOTOXIC-SHOCK; TNF-ALPHA; MEMBRANES; SEPSIS; HEMODYNAMICS; FAILURE;
Keywords:
haemofiltration; shock; sepsis; septic shock; acute renal failure; haemodialysis; multi-organ failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Bellomo, R Austin & Repatriat Med Ctr, Dept Intens Care, Melbourne, Vic, Australia Austin & Repatriat Med Ctr Melbourne Vic Australia Australia
Citazione:
L. Cole et al., "High-volume haemofiltration in human septic shock", INTEN CAR M, 27(6), 2001, pp. 978-986

Abstract

Objective: To evaluate whether high volume haemofiltration improves haemodynamics and affects serum cytokine and complement concentrations in human septic shock. Design and setting: Randomized cross-over clinical trial in a tertiary intensive care unit. Patients: Eleven patients with septic shock and multi-organ failure. Interventions: Patients were assigned to either 8 h of high-volume haemofiltration (HVHF; 6 1/h) or 8 h of standard continuous veno-venous haemofiltration (CVVH; 1 1/h) in random order. Measurements and main results. We measured changes in haemodynamic variables, dose of norepinephrine required to maintain a mean arterial pressure greater than 70 mmHg and plasma concentrations of complement anaphylatoxins and several cytokines. An 8-h period of HVHF was associated with a greater reduction in norepinephrine requirements than a similar period of CVVH (median reduction: 10.5 vs. 1.0 mug/min; p = 0.01; median percentage reduction: 68 vs. 7%; p = 0.02), Both therapies were associated with a temporary reduction (p < 0.01) in the plasma concentration of C3a, C5a, and interleukin 10within 2 h of initiation. HVHF was associated with a greater reduction in the area under the curve for C3a and C5a (p < 0.01). The concentration of the measured soluble mediators in the ultrafiltrate was negligible. Conclusions: HVHF decreases vasopressor requirements in human septic shockand affects anaphylatoxin levels differently than standard CVVH.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/06/20 alle ore 02:11:09